Reduced Regional Grey Matter Volumes in Pediatric Obstructive Sleep Apnea

Mona F Philby,Paul M Macey,David Gozal,Richard A Ma,Leila Kheirandish-Gozal,Rajesh Kumar

doi:10.1038/srep44566

Mona F Philby, Paul M Macey + Show 4 more

Open Access

https://doi.org/10.1038/srep44566

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Abstract

Pediatric OSA is associated with cognitive risk. Since adult OSA manifests MRI evidence of brain injury, and animal models lead to regional neuronal losses, pediatric OSA patients may also be affected. We assessed the presence of neuronal injury, measured as regional grey matter volume, in 16 OSA children (8 male, 8.1 ± 2.2 years, AHI:11.1 ± 5.9 events/hr), and 200 control subjects (84 male, 8.2 ± 2.0 years), 191 of whom were from the NIH-Pediatric MRI database. High resolution T1-weighted whole-brain images were assessed between groups with voxel-based morphometry, using ANCOVA (covariates, age and gender; family-wise error correction, P < 0.01). Significant grey matter volume reductions appeared in OSA throughout areas of the superior frontal and prefrontal, and superior and lateral parietal cortices. Other affected sites included the brainstem, ventral medial prefrontal cortex, and superior temporal lobe, mostly on the left side. Thus, pediatric OSA subjects show extensive regionally-demarcated grey matter volume reductions in areas that control cognition and mood functions, even if such losses are apparently independent of cognitive deficits. Since OSA disease duration in our subjects is unknown, these findings may result from either delayed neuronal development, neuronal damaging processes, or a combination thereof, and could either reflect neuronal atrophy or reductions in cellular volume (neurons and glia).

Highlights

One of the major consequences of pediatric OSA consists in the increased risk for severity-dependent cognitive and behavioral deficits, and poor school performance[3,4,5,6,7,8,9,10,11]
Regardless of the origin of these volume reductions, altered regional grey matter is likely impacting brain functions, and cognitive development potential may be at risk in children with OSA
Group differences reported were of sufficient magnitude and consistency to pass the stringent statistical criteria set forth by the multivariate analyses and post-hoc tests applied

Summary

Introduction

One of the major consequences of pediatric OSA consists in the increased risk for severity-dependent cognitive and behavioral deficits, and poor school performance[3,4,5,6,7,8,9,10,11]. The present study aimed to assess the presence of potential injury to neuronal areas measured as reduced grey matter volume in a group of pediatric OSA patients relative to a large set of comparable control subjects.

Results

Conclusion